Individual provider Active NPI

Jennie Lee Basarich, LMFT

  • Marriage & Family Therapist
  • Davis, CA
National Provider Identifier
1811299563
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
53333 Issued in CA
Practice address
103 Huerta PL
Davis, CA 95616-0270
Phone
(707) 477-8957
Fax
(530) 564-3280
NPI assigned
Dec 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 53333 CA Primary

Addresses

Primary practice location

103 Huerta PL
Davis, CA 95616-0270

Mailing address

103 Huerta PL
Davis, CA 95616-0270
Phone (707) 477-8957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 19, 2024 through Jan 19, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
53333CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1811299563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 HUERTA PL",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956160270",
            "telephone_number": "707-477-8957",
            "fax_number": "530-564-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 HUERTA PL",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956160270",
            "telephone_number": "707-477-8957",
            "fax_number": "530-564-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASARICH",
        "first_name": "JENNIE",
        "middle_name": "LEE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "53333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.